摘要：
Aim To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
Background Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Design A cross-sectional study.
A cross-sectional study.
Methods This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
Results A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
Conclusions Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
期刊：
FRONTIERS IN ONCOLOGY,2025年15:1515502 ISSN：2234-943X
通讯作者：
Yan, YY
作者机构：
[Mo, Wenjuan; Li, Mengnan] Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Yan, YY; Yan, Yuanyuan; Fu, Guang] Univ South China, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hengyang, Peoples R China.
通讯机构：
[Yan, YY ] U;Univ South China, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hengyang, Peoples R China.
关键词：
best evidence;gastric cancer;intervention strategies;prevention;pulmonary complications
摘要：
BACKGROUND: Postoperative pulmonary complications in gastric cancer surgery significantly impact patient recovery and prognosis. These complications, including infections, can increase hospital stays and costs, and even lead to death. Numerous risk factors are involved, such as age, smoking history, and lung function. Although preventive measures exist, a unified and effective strategy is lacking. Therefore, researching and implementing effective prevention measures is crucial for improving patients' postoperative quality of life and survival rates. AIM: To collate and summarize the best available evidence for the prevention of pulmonary complications in patients undergoing gastric cancer surgery, thereby providing a reference for the clinical development of relevant intervention strategies. METHODS: A literature search was conducted in databases including BMJ Best Practice, UpToDate, JBI, Cochrane Library, PubMed, Embase, the Ontario Nurses Registration Network, the U.S. National Clinical Practice Guidelines, and MedLine, for documents related to the prevention of pulmonary complications in gastric cancer surgery patients. The search period extended from the inception of these databases to July 25, 2024. The quality of the literature was evaluated according to the standards of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, and evidence was extracted from the included documents. RESULTS: A total of 27 documents were ultimately included. The extracted content encompassed three areas: preoperative assessment, risk prevention and intervention measures, totaling 31 best evidences across five categories. The findings of our study underscore the significance of comprehensive preoperative assessments, such as the ARISCAT index for pulmonary risk evaluation, and stress the importance of preoperative interventions like inspiratory muscle training, smoking cessation, and oral care in mitigating postoperative pulmonary complications (PPCs) following gastric cancer surgery. We also advocate for the adoption of protective lung ventilation strategies during surgery and continuous pulse oximetry monitoring postoperatively, along with targeted treatments for specific complications. CONCLUSION: The best evidence extracted for the prevention of complications in gastric cancer surgery patients serves as a basis for evidence-based practice for the prevention of pulmonary complications in this patient group. Further research topics on pulmonary complications of gastric cancer, we recommend further optimization of preoperative assessment tools, investigation into the efficacy of smoking cessation programs, comparative studies on intraoperative ventilation strategies, development of postoperative rehabilitation programs, and research into culturally and resource-sensitive interventions to broaden the global applicability of these practices.
摘要：
China is experiencing an increasingly serious aging population. Cognitive function is an important factor and guarantee for the quality of life of older people. Therefore, to achieve healthy aging, this study aimed to examine the sequential multiple mediating effects of indoor ventilation frequency and cognitive function on anxiety and self-rated health in the Chinese older people population. Using the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, we finally selected 10,372 Chinese seniors over the age of 65. First, we describe the basic socio-demographic information of the sample population. Second, Spearman correlation analysis was used to determine whether there was a correlation between indoor ventilation frequency, anxiety, self-rated health, and cognitive function among Chinese older people. Finally, the SPSS macro process program was used to complete the sequence multiple mediation analysis. Indoor ventilation frequency, anxiety, self-rated health and cognitive function were significantly correlated (p < 0.01). Indoor ventilation frequency not only has a direct positive impact on the cognitive function of older people (effect = 0.1427; Standard error = 0.0201; 95%CI: LL = 0.1034, UL = 0.1821), but also indirectly affected cognitive function through three pathways: independent mediation of anxiety (effect = 0.0078; Standard error = 0.0021; 95%CI: LL = 0.0041, UL = 0.0121), independent mediating effect of self-rated health (effect = 0.0154; Standard error = 0.0030; 95%CI: LL = 0.0098, UL = 0.0215), and the chain mediating effect between anxiety and self-rated health (effect = 0.0046; Standard error = 0.0009; 95%CI: LL = 0.0029, UL = 0.0065). All projects are self-reported and some results may be biased. In the future, it may be more inspiring to explore more detailed and specific effects of indoor air quality on cognitive function in older people. Studies have shown that indoor ventilation frequency can improve cognitive function by reducing anxiety and improving self-rated health in older people Chinese. Encouraging older adults to increase the frequency of indoor ventilation will benefit their mental health and cognitive function. This study provides empirical evidence for the association between indoor ventilation frequency and cognitive function in older people Chinese adults. We used nationally representative data to investigate the relationship between indoor ventilation frequency and cognitive function and further explored the mediating role of anxiety and self-rated health in Chinese older adults. Indoor ventilation frequency can not only directly affect cognitive function in older people, but also indirectly affect cognitive function through anxiety and self-rated health. Anxiety and self-rated health have a series of mediating effects between indoor ventilation frequency and cognitive function.
摘要：
AIMS: Although anxiety and depression are frequently linked to coronary heart disease, a network analysis of comorbid anxiety and depression and their association with quality of life in patients undergoing percutaneous coronary intervention (PCI) remains unclear from the perspective of symptom interactions. We aimed to investigate the network structure and symptom patterns of anxiety and depression, and their relationship with quality of life in patients undergoing PCI. METHODS AND RESULTS: This study included 528 patients undergoing PCI. The seven-item Generalized Anxiety Disorder Scale, nine-item Patient Health Questionnaire, and World Health Organization Quality of Life Questionnaire-Brief Version were used as measurement tools. The R software was used to construct and interpret the network structure. The symptoms "sleep disturbance," "irritability," and "uncontrollable worry" showed the highest expected influence centrality. Three bridge symptoms were identified: "sleep disturbance," "excessive worry," and "trouble relaxing." Among the three strongest edges, two were associated with anxiety and depressive symptoms. Ten symptoms were directly associated with quality of life, with "fatigue" showing the strongest relationship. In the network comparison test, significant differences in global strength were observed between the male and female groups. CONCLUSION: "Sleep disturbance," plays a critical role in the current network, while "excessive worry," "trouble relaxing," and "fatigue" were identified as key priorities owing to their high correlation with "sleep disturbance" and quality of life. Focusing on these symptoms may help mitigate the risk of multiple-symptom interactions and provide tailored intervention measures for patients undergoing PCI. REGISTRATION: Chinese Clinical Trial Registry ChiCTR230007581.
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100702 ISSN：2347-5625
通讯作者：
Chen, YY
作者机构：
[Guo, Junchen; Xu, Xianghua; Chen, Yongyi; Hu, Yonghong] Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.;[Guo, Junchen] Univ Wollongong, Sch Nursing, Wollongong, NSW, Australia.;[Zeng, Linghao] Univ South China, Sch Nursing, Hengyang, Peoples R China.;[Dai, Yunyun] Univ Wollongong, Hlth Serv Res Inst, Wollongong, NSW, Australia.
通讯机构：
[Chen, YY ] H;Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.
关键词：
Palliative care;Shared-care management;Delphi technique;End of life care
摘要：
Objective Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original healthcare providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original healthcare providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Methods Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Results The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73-5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73-5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
Conclusions The establishment of the standard in this study provides a critical framework that can be adopted by healthcare institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
The establishment of the standard in this study provides a critical framework that can be adopted by healthcare institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
摘要：
BACKGROUND: To investigate the association between indoor ventilation frequency and symptoms of depression and anxiety in older persons. METHODS: A binary logistic regression model was used to analyze the effects of indoor ventilation frequency on depression and anxiety by using data from the 2018 Chinese longitudinal healthy longevity survey (CLHLS). RESULTS: A total of 9,690 older persons with an average age of (83.20 ± 11.27) years were included, including 4,458 males (46.0%) and 5,232 females (54.0%). The average score of indoor ventilation frequency was (6.06 ± 1.98) points, including 770 people (7.9%) with low frequency, 3,066 people (31.6%) with medium frequency, and 5,854 people (60.4%) with high frequency. 842 (8.7%) had symptoms of depression and 204 (2.1%) had symptoms of anxiety. Compared with the older persons with low indoor ventilation frequency, the older persons with higher ventilation frequency had a lower incidence of depression (OR(95%CI) = 1.92 (1.50 ∼ 2.46), 1.51 (1.27 ∼ 1.79); P < 0.001). However indoor ventilation frequency was not associated with anxiety symptoms. CONCLUSION: Indoor ventilation frequency is related to depressive symptoms in older persons. Communities and families should pay more attention to indoor ventilation and intervene in time to promote and improve the mental health of older persons.
期刊：
Journal of Orthopaedic Surgery and Research,2025年20(1):1-8 ISSN：1749-799X
通讯作者：
Zhou, YH;Huang, HY
作者机构：
[He, Yulian; Liu, Bo; Tang, Wen; Yuan, Runzhi] Univ South China, Affiliated Hosp 1, Dept Orthoped Ctr, Hengyang Med Sch, Hengyang City 421001, Hunan Prov, Peoples R China.;[Wang, Yiqi] Univ South China, Sch Nursing, Hengyang City 421001, Hunan Prov, Peoples R China.;[Zhou, Yanhui] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;[Huang, Huayong; Huang, HY] Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
通讯机构：
[Huang, HY ; Zhou, YH ] U;Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
关键词：
Early rehabilitation;Hospital stay;Postoperative complications;Elderly patients;Hip fracture;A prospective cohort study
摘要：
Hip fractures in the elderly are a major global public health concern, with incidence projected to rise as populations age. Rehabilitation is critical to recovery after hip fracture surgery, but the ideal timing for initiation remains uncertain. While early rehabilitation, within 48 h post-surgery, is associated with better outcomes, its specific impact on hospital stay duration and postoperative complications is not yet conclusively established. This study aims to evaluate the effects of initiating rehabilitation within 48 h after hip fracture surgery on hospital length of stay and postoperative complications, compared to rehabilitation started one-week post-surgery in elderly patients. It is hypothesized that early rehabilitation will significantly reduce hospital stays and decrease the rate of postoperative complications. In this prospective cohort study, patients aged 65 and older are divided into early rehabilitation (within 48 h) and delayed rehabilitation (after one week) groups. Data will be collected using electronic medical records (EMR), standardized clinical tools (Barthel Index, Timed Up and Go), and patient-reported outcome measures (SF-36, EQ-5D). Statistical analyses will include t-tests and chi-square tests for outcome comparison, with multiple regression adjusting for potential confounders such as age, gender, and comorbidities. This study addresses a gap in current research by comparing early versus delayed rehabilitation for elderly hip fracture patients. The findings will contribute to the development of evidence-based rehabilitation protocols aimed at optimizing recovery, reducing complications, and improving the efficient use of medical resources.
摘要：
Background Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Objectives To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
Methods We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
Results The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
Conclusion This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
摘要：
Hypertrophic scarring (HS) is a fibrotic skin disorder characterized by excessive deposition of extracellular matrix (ECM), leading to symptoms such as pain, itching, and skin contraction. HS can also result in restricted joint mobility and cosmetic deformities, imposing psychological and economic burdens on patients. Additionally, it increases wound care costs, and currently, no ideal treatment options exist. Therefore, HS is not only a clinical care issue but also a societal problem, with significant challenges related to its management and prevention. In this study, a custom-made cepharanthine ointment was applied to a rabbit ear scar model to investigate its effects on morphology, histology, and protein expression in HS. Additionally, the mechanism underlying the effect of cepharanthine on affected fibroblasts and the expression of ECM proteins was explored in vitro models of fibrosis. Animal experiments demonstrated that cepharanthine significantly reduced the tissue scar hypertrophy index and collagen content, improved the arrangement of fibroblasts, and inhibited ECM production. Cellular experiments indicated that cepharanthine effectively downregulated key proteins in the TGF-β/SMAD pathway, decreased ECM protein expression, and suppressed fibroblast proliferation and migration. Cepharanthine can prevent HS by reducing ECM deposition through the TGF-β/SMAD signalling pathway.
作者机构：
[Li, C.; Hu, A.; You, Z.] Jinhua Univ Vocat Technol, Sch Med, Jinhua 321000, Zhejiang, Peoples R China.;[Liu, X.; Liu, Y.; Liu, F.; Liao, L.] Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.;[Li, W.; Liu, F.] Univ South China, Affiliated Hosp 1, Cardiac Intervent Imaging Ctr, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;[Liu, F.] Chiang Mai Univ, Fac Nursing, PhD Degree Program, Chiang Mai 50000, Thailand.
通讯机构：
[Liu, F ] U;Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.;Univ South China, Affiliated Hosp 1, Cardiac Intervent Imaging Ctr, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;Chiang Mai Univ, Fac Nursing, PhD Degree Program, Chiang Mai 50000, Thailand.
摘要：
objective: To assess the variations in radiation dose at different areas in the cardiac catheterization room during cardiac catheterization interventions. methods:To simulate the conventional operation in cardiac catheterization interventions, perform angiography on standard manikins ,the radiation dose was collected from 22 areas in the cardiac catheterization room under 8 projection angles, and each area was repeated 5 times, and the collected data was analyzed using one-way ANOVA and independent sample t-test. results:Analysis of the radiation dose in 22 areas under 8 projection angles revealed that the lowest radiation dose was found in the area at the end of the operating table in the cardiac catheterization room (p < 0.05), and the highest radiation dose was found in the area on the left and right sides of the X-ray tube (p < 0.05); the radiation dose in the area on the right side of the X-ray tube of the DSA machine was greater than that in the conventional standing area of the first operator (p < 0.05)，and the radiation dose in the conventional standing area of the second operator was greater than that in the conventional standing area of the first operator (p < 0.05); the radiation dose in the standing area of the first operator was highest in the cephalic position (CRA 30°) (p < 0.05), and the radiation dose in the standing area of the second operator was highest in the left anterior oblique position (LAO 45°) (p < 0.05); in the angle of RAO projection, the radiation dose in the right area of the X-ray tube was greater than that in the left area of the X-ray tube (p < 0.05). Under the RAO projection angle, the radiation dose from the right side of the X-ray tube of the DSA machine was greater than that from the left side (p<0.05), and the result was reversed at the projection angle of the LAO. conclusion:The radiation dose during cardiac catheterization interventions is lowest in the area at the end of the operating table, which can be used as a standing area for nurses and as an area for the placement of surgical equipment and supplies. At the same time, it is necessary to pay attention to the radiation dose to the second operator and to further improve the radiation protection measures for the second operator, and additional measures are needed to minimize the radiation dose to the operators in the cephalic position (CRA 30°) and in the left anterior oblique position (LAO 45°).
作者机构：
[You, Jia-Chun; Xu, Chao-Yue; Li, Shu-Lin; Huang, YJ; Huang, Yan-Jin; He, Zhi-Qing] Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Zou, Ping] Nipissing Univ, Sch Nursing, North Bay, ON, Canada.;[Chen, Xi] Hong Kong Polytech Univ, Sch Nursing, Hong Kong, Peoples R China.
通讯机构：
[Huang, YJ ] U;Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.
摘要：
INTRODUCTION: Stroke presents a considerable burden not only to patients but also to their families and society at large. In many instances, stroke patients opt for home rehabilitation, relying on family caregivers for daily assistance. This dynamic significantly influences the physiological, psychological and social well-being of these caregivers. Despite its importance, the phenomenon of self-regulatory fatigue (SRF) among family caregivers has received insufficient attention in the literature. Therefore, the objective of this study is to investigate the levels of SRF, the characteristics of associated symptoms and the trajectories of symptom change experienced by family caregivers of stroke patients. METHODS AND ANALYSIS: This research employs a mixed-methods approach, combining a cross-sectional study with a prospective longitudinal quantitative and qualitative design. The Chinese version of the SRF Scale and the Chinese version of Patient-Reported Outcomes Measurement Information System profile-29 are used to assess SRF, psychological and physiological symptoms, and related functional outcomes among family caregivers of stroke patients. Latent class growth analysis will be employed to model the heterogeneous developmental trajectories of SRF-related symptoms among family caregivers of stroke patients. Reflexive thematic analysis will be employed to analyse, organise and summarise qualitative data, to identify the experiences and management needs related to SRF among family caregivers during home care. Through this comprehensive mixed-methods approach, the study aims to: investigate the levels of SRF experienced by family caregivers of stroke patients, identify patterns and trajectories of related symptoms. The integration of cross-sectional and longitudinal data allows for a thorough examination of both immediate and long-term aspects of caregiver experiences, providing valuable insights into the complex dynamics of SRF in this population. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Ethics Committee of the University of South China (approval number 2023-NHHL-051). Data collection was authorised by the ethics committees of the First Affiliated Hospital, Second Affiliated Hospital and Nanhua Affiliated Hospital of the University of South China. The results of this study will be disseminated through publication in pertinent peer-reviewed journals, presentation at local and international conferences, and communication with all relevant stakeholders. TRIAL REGISTRATION NUMBER: ChiCTR2400082717.
摘要：
Chlamydia trachomatis Pgp3 protein-induced immunoprotection is effective but incomplete, which requires the suitable adjuvants to enhance its immune response. Within this context, Hepatitis B core virus-like particles (HBc-VLP) emerge as nanoscale protein particles capable of incorporating either endogenous or exogenous antigens or epitopes. In this study, HBc-Pgp3 chimeric protein was accomplished by integrating the identified dominant epitope of the Pgp3 protein into the major immunodominant region of a truncated HBc-VLP, which was realized in the pET28a (+) vector and expressed via the E. coli BL21 expression system. The efficacious expression and purification of the recombinant HBc-Pgp3 facilitated a tripartite immunization regimen in mice. The immunological assessment encompassed the measurement of IgG antibody and cytokine levels through ELISA, alongside flow cytometric analysis of the CD4+ Th1 cell-mediated immune responses within the murine spleen. Comparative analysis revealed that the HBc-Pgp3-vaccinated mice demonstrated superior IgG antibody titers and subtypes relative to the controls. Moreover, the HBc-Pgp3 formulation was instrumental in augmenting IFN-γ production, enhancing the efficiency of Chlamydia muridarum clearance post-challenge, and severity of hydrosalpinx within the lower genital tract. Collectively, these findings illuminate the potential of the novel HBc-Pgp3 chimeric construct as an innovative vaccine candidate, offering augmented immunoprotection against chlamydial infection.
Chlamydia trachomatis Pgp3 protein-induced immunoprotection is effective but incomplete, which requires the suitable adjuvants to enhance its immune response. Within this context, Hepatitis B core virus-like particles (HBc-VLP) emerge as nanoscale protein particles capable of incorporating either endogenous or exogenous antigens or epitopes. In this study, HBc-Pgp3 chimeric protein was accomplished by integrating the identified dominant epitope of the Pgp3 protein into the major immunodominant region of a truncated HBc-VLP, which was realized in the pET28a (+) vector and expressed via the E. coli BL21 expression system. The efficacious expression and purification of the recombinant HBc-Pgp3 facilitated a tripartite immunization regimen in mice. The immunological assessment encompassed the measurement of IgG antibody and cytokine levels through ELISA, alongside flow cytometric analysis of the CD4+ Th1 cell-mediated immune responses within the murine spleen. Comparative analysis revealed that the HBc-Pgp3-vaccinated mice demonstrated superior IgG antibody titers and subtypes relative to the controls. Moreover, the HBc-Pgp3 formulation was instrumental in augmenting IFN-γ production, enhancing the efficiency of Chlamydia muridarum clearance post-challenge, and severity of hydrosalpinx within the lower genital tract. Collectively, these findings illuminate the potential of the novel HBc-Pgp3 chimeric construct as an innovative vaccine candidate, offering augmented immunoprotection against chlamydial infection.
摘要：
Objective This study examined the heterogeneity of illness perceptions in patients with lung cancer and evaluated the mediating role of self-transcendence in the relation between illness perception and demoralization.
This study examined the heterogeneity of illness perceptions in patients with lung cancer and evaluated the mediating role of self-transcendence in the relation between illness perception and demoralization.
Methods A convenience sample of 477 patients with lung cancer was selected from three tertiary hospitals in Wuhan, China, between January and June 2024. Participants completed the Brief Illness Perception Questionnaire, Self-Transcendence Scale, and Demoralization Scale. Data were analyzed using Mplus 8.3 and SPSS 25.0.
A convenience sample of 477 patients with lung cancer was selected from three tertiary hospitals in Wuhan, China, between January and June 2024. Participants completed the Brief Illness Perception Questionnaire, Self-Transcendence Scale, and Demoralization Scale. Data were analyzed using Mplus 8.3 and SPSS 25.0.
Results Three latent illness perception profiles were identified among patients with lung cancer: low (27.25%), moderate (40.04%), and high (32.71%). Mediation analyses revealed a partial mediation effect in the relation between illness perception and demoralization in the low versus moderate (SE = 1.56, 95% CI = 14.71, 20.86) and high versus low illness perception groups (SE = 1.71, 95% CI = 35.44, 42.71).
Three latent illness perception profiles were identified among patients with lung cancer: low (27.25%), moderate (40.04%), and high (32.71%). Mediation analyses revealed a partial mediation effect in the relation between illness perception and demoralization in the low versus moderate (SE = 1.56, 95% CI = 14.71, 20.86) and high versus low illness perception groups (SE = 1.71, 95% CI = 35.44, 42.71).
Conclusions Patients with lung cancer exhibited heterogeneous illness perceptions, and self-transcendence partially mediated the relation between illness perception and demoralization. Promoting self-transcendence may help mitigate the negative impact of illness perceptions on demoralization. Clinical interventions aimed at reducing negative illness perceptions and enhancing self-transcendence should be prioritized in the care of patients with lung cancer.
Patients with lung cancer exhibited heterogeneous illness perceptions, and self-transcendence partially mediated the relation between illness perception and demoralization. Promoting self-transcendence may help mitigate the negative impact of illness perceptions on demoralization. Clinical interventions aimed at reducing negative illness perceptions and enhancing self-transcendence should be prioritized in the care of patients with lung cancer.
通讯机构：
[Liao, L ] U;Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.
关键词：
lymphedema;breast cancer survivors;social relationships;meta-aggregation
摘要：
Background: Breast Cancer-Related Lymphedema (BCRL) is a chronic condition requiring lifelong care, impacting survivors' quality of life. Social relationships play a crucial role in survivorship, yet research on their broader impact remains limited. Many Breast Cancer Survivors with Lymphedema (BCSWL) struggle with work, relationships, and self-esteem. This review explores their social experiences to inform healthcare strategies and improve self-management. Method: Based on the Joanna Briggs Institute meta-aggregation approach, article screening and data analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The quality of the screened articles was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (JBI-QARI), and the Confidence in the Qualitative Synthesis of Findings (ConQual) approach was conducted to grade aggregated findings. Results: This review included 14 studies and focused primarily on 4 types of relationships: family, work colleagues, romantic relationships, and all relational partners (with some papers discussing overlapping relationship themes). We identified 4 synthesized findings that explore the experiences of BCSWL under different social relationships: (a) negotiating health and role expectations, (b) experiencing psychosocial pressure and stigmatization, (c) experiencing support from social networks, and (d) developing adaptive resilience and identity reconstruction. Conclusions: BCSWL experience complex and multifaceted outcomes within various social relationships, with both positive and negative experiences shaping their health and well-being. Findings indicate that BCSWL often face heightened role conflicts in workplace and family settings, compounded by a lack of adequate support. They are also particularly vulnerable to psychosocial pressures and stigmatization in romantic relationships. Despite these challenges, BCSWL demonstrate remarkable resilience, effectively navigating these difficulties across different relational contexts. Receiving support from relational networks throughout their lifelong treatment is crucial for their overall health and well-being.
摘要：
Purpose The study aimed to identify the profiles of psychological flexibility in patients with cervical cancer and how self-perceived burden networked to different psychological flexibility profiles.
The study aimed to identify the profiles of psychological flexibility in patients with cervical cancer and how self-perceived burden networked to different psychological flexibility profiles.
Methods The Personalized Psychological Flexibility Index and the Self-Perceived Burden for Cancer Patients were used to measure psychological flexibility and self-perceived burden in patients from the “Be Resilient to Cancer” project. Latent profile analysis was used to identify profiles and computer-simulated network analysis was conducted to determine if self-perceived burden networked to any of the psychological flexibility profiles.
The Personalized Psychological Flexibility Index and the Self-Perceived Burden for Cancer Patients were used to measure psychological flexibility and self-perceived burden in patients from the “Be Resilient to Cancer” project. Latent profile analysis was used to identify profiles and computer-simulated network analysis was conducted to determine if self-perceived burden networked to any of the psychological flexibility profiles.
Results A total of 325 patients with cervical cancer were recruited in this study. Mean age was 42.26 years, the majority were married (71%) and 75.4% had early stage disease (I or II). Three profiles of psychological flexibility were identified: moderate avoidance-low acceptance/harnessing (34.8%), high avoidance-moderate acceptance/harnessing (36.9%), low avoidance and high acceptance/harnessing (28.3%). Furthermore, “worrying about damaging family relationships” and “feeling guilty about affecting family's life plans” were the most bridge symptoms as well as the targeted intervention symptoms for alleviating and aggravating the self-perceived burden respectively.
A total of 325 patients with cervical cancer were recruited in this study. Mean age was 42.26 years, the majority were married (71%) and 75.4% had early stage disease (I or II). Three profiles of psychological flexibility were identified: moderate avoidance-low acceptance/harnessing (34.8%), high avoidance-moderate acceptance/harnessing (36.9%), low avoidance and high acceptance/harnessing (28.3%). Furthermore, “worrying about damaging family relationships” and “feeling guilty about affecting family's life plans” were the most bridge symptoms as well as the targeted intervention symptoms for alleviating and aggravating the self-perceived burden respectively.
Conclusion Three patterns of psychological flexibility were recognized with two symptoms might be targeted to improve the self-perceived burden in women with cervical cancer.
Three patterns of psychological flexibility were recognized with two symptoms might be targeted to improve the self-perceived burden in women with cervical cancer.
摘要：
This research seeks to thoroughly examine the present state and research hotspots in Mendelian randomization (MR) in osteoporosis (OP)-related fields, providing a reference for future research directions in this area. Following an exhaustive search of the Web of Science Core Collection database, our analysis utilized citation statistics for osteoporosis studies conducted from January 1, 2007, through March 15, 2024. Bibliometric and visual analyses were conducted using two online analysis systems, CiteSpace and VOSviewer. The analysis included a variety of dimensions, including the distribution of citations, authorship, published journals, year of publication, countries, co-occurrence keywords and keyword clustering. From 2007 to 2024, the number of publications in MR in OP-related fields showed an overall increased. High-impact publications and leading contributors were primarily from China, followed by the USA and England. The journal with the largest number of publications in MR in OP-related fields is the Journal of Bone and Mineral Research. Risk factor research, genome-wide associations, meta-analysis, fractures, and gene loci were the main research hotspots. Interdisciplinary integration, MR research combined with data from clinical trials and observational studies, represents the future development trend. Research on MR in OP-related fields has mainly been conducted in China, the USA, and England. The research hotspots were aimed at exploring the causative between risk factors and OP. Future studies are likely to center on multidisciplinary integration.
摘要：
BACKGROUND: Over the past 50 years, doctor-patient interactions have moved from paternalistic to patient-centered, emphasizing shared decision-making (SDM). SDM, which involves healthcare professionals and patients making clinical decisions together, is crucial for patient autonomy and is promoted worldwide, yet remains challenging to implement effectively. Our systematic review analyses the influencing factors of implementing shared decision-making in patients with colorectal cancer and summarizes coping strategies. MATERIALS AND METHODS: A systematic search of the PubMed, Embase, Cochrane Library, Web of Science (Core library), Ovid, and EBSCO databases was performed from database inception to 1 September 2024 using a combination of subject words and free words. Qualitative studies on the factors affecting SDM for patients with gastrointestinal cancer were identified, the literature quality was evaluated using the Australian JBI Evidence-based Health Care Center quality evaluation standards for qualitative research, and the results were integrated by a pooled integration method. RESULTS: A total of 37 results were extracted through meta-analysis, summarized into 9 themes, and summarized into 2 subthemes. The results were classified for nonmutually exclusive cases. CONCLUSIONS: Medical staff should fully understand patients' needs and preferences for disease and treatment information, strengthen their communication skills regarding SDM, and actively provide effective treatment and care information for patients and their families to promote the implementation of SDM for patients with gastrointestinal tumors.
期刊：
International Journal of Medical Informatics,2025年195:105738 ISSN：1386-5056
通讯作者：
Hu, Li;Zeng, GQ
作者机构：
[Zeng, Mi; Wang, Manyi; Hu, Li; Zeng, Guqing; Li, Zhuolan; Wu, Jingjing; Zeng, Qingqing] Univ South China, Hengyang Med Sch, Sch Nursing, 28 Changsheng Rd West, Hengyang 421001, Hunan, Peoples R China.;[Zeng, Mi; Wang, Manyi; Zeng, Guqing; Li, Zhuolan; Wu, Jingjing; Hu, Li] Univ South China, Sch Enterprise Cooperat Innovat & Entrepreneurship, Hunan Lantern Med Technol Co Ltd, Hengyang, Peoples R China.;[Gui, Sijie] Univ South China, Affiliated Hosp 1, Dept Orthoped & Trauma, Hengyang, Peoples R China.;[Zeng, Qingqing] Army Med Univ, Affiliated Hosp 1, Hosp Chinese Peoples Liberat Army 958, Jiangbei Campus,29 Jianxindong St, Chongqing 400038, Peoples R China.;[Miao, Wanyu] Chongqing Univ Technol, Coll Comp Sci & Engn, Chongqing, Peoples R China.
通讯机构：
[Hu, L; Zeng, GQ ] U;Univ South China, Hengyang Med Sch, Sch Nursing, 28 Changsheng Rd West, Hengyang 421001, Hunan, Peoples R China.
关键词：
Hip fractures;Re-fracture;Automatic machine learning;Prediction models
摘要：
Objective The aim of study was to construct a postoperative re-fracture prediction model for elderly hip fracture patients using an automated machine learning algorithm to provide a basis for early identification of patients with high risk of re-fracture occurrence.
The aim of study was to construct a postoperative re-fracture prediction model for elderly hip fracture patients using an automated machine learning algorithm to provide a basis for early identification of patients with high risk of re-fracture occurrence.
Methods Clinical data were collected and subjected to univariate and multivariate analyses to determine the independent risk factors affecting postoperative re-fracture of hip fracture in the elderly. The collected data were divided into training and validation sets in a ratio of 7:3, AutoGluon was applied to construct LightGBMXT, LightGBM, RandomForestGini, RandomForestEntr, CatBoost, NeuralNetFastAI, XGBoost, NeuralNetTorch, LightGBMLarge and WeightedEnsemble_L2 prediction models, and the constructed models were evaluated using evaluation indicators. The models were externally validated and the model with the best prediction performance was selected.
Clinical data were collected and subjected to univariate and multivariate analyses to determine the independent risk factors affecting postoperative re-fracture of hip fracture in the elderly. The collected data were divided into training and validation sets in a ratio of 7:3, AutoGluon was applied to construct LightGBMXT, LightGBM, RandomForestGini, RandomForestEntr, CatBoost, NeuralNetFastAI, XGBoost, NeuralNetTorch, LightGBMLarge and WeightedEnsemble_L2 prediction models, and the constructed models were evaluated using evaluation indicators. The models were externally validated and the model with the best prediction performance was selected.
Results The incidence of postoperative re-fracture was about 11.7%, and age, comorbid diabetes mellitus, comorbid osteoporosis, rehabilitation exercise status, and preoperative total protein level were considered as independent risk factors. The top three models in terms of AUC values in the training set were WeightedEnsemble_L2 (0.9671), XGBoost (0.9636), and LightGBM (0.9626), the WeightedEnsemble_L2 (0.9759) was best in the external validation. Based on the AUC and other evaluation indicators, WeightedEnsemble_L2 was considered the model with the best prediction performance.
The incidence of postoperative re-fracture was about 11.7%, and age, comorbid diabetes mellitus, comorbid osteoporosis, rehabilitation exercise status, and preoperative total protein level were considered as independent risk factors. The top three models in terms of AUC values in the training set were WeightedEnsemble_L2 (0.9671), XGBoost (0.9636), and LightGBM (0.9626), the WeightedEnsemble_L2 (0.9759) was best in the external validation. Based on the AUC and other evaluation indicators, WeightedEnsemble_L2 was considered the model with the best prediction performance.
Conclusion The constructed model is highly generalizable and applicable, and can be used as an effective tool for healthcare professionals to assess and manage patients’ risk of re-fracture.
The constructed model is highly generalizable and applicable, and can be used as an effective tool for healthcare professionals to assess and manage patients’ risk of re-fracture.
作者机构：
[Su, Yinhua; Li, Zhongyu; Su, YH; Li, ZY; Guo, Yu; Yu, Huixi; Li, Hanbing; Shangguan, Fuliang; Liu, Hui] Hengyang Med Sch, Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Liu, Fen] Univ South China, Affliated Hosp 1, Hengyang, Hunan, Peoples R China.
通讯机构：
[Su, YH; Li, ZY ] H;Hengyang Med Sch, Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.
摘要：
Background Time-restricted eating (TRE) manages weight effectively, but choosing how long and what time window remain debatable. Although an 8:00 a.m. to 16:00 p.m. time frame is reported to show positive results in most weight loss trial, its safety and efficacy in overweight and obese women with polycystic ovary syndrome (PCOS) is uncertain. This randomized controlled trial is conducted to evaluate the safety and efficacy of TRE in specific populations. Objective This study aims to assess the 6-month effects of TRE on weight change, metabolic improvement, reproductive recovery, and health-related quality of life in overweight and obese women with polycystic ovary syndrome (PCOS), compared to those who did not receive TRE. Methods This randomized controlled trial will enroll 96 overweight and obese women with polycystic ovary syndrome (PCOS), who will be randomly assigned to either a TRE group (with an eating window from 8:00 a.m. to 16:00 p.m.) or a control group (without eating time restrictions), with 49 participants in each group. Evaluators and data analysts will remain blinded to group allocation throughout the study. The primary outcomes, including changes in weight and body mass index (BMI), will be assessed weekly. Secondary outcomes, encompassing alterations in sex hormones, metabolic parameters, body composition, sleep quality, quality of life, anxiety, and depression, will be evaluated monthly. Compliance and safety will be continuously monitored throughout the study. Additionally, a 6-month follow-up will be conducted at the end of the trial to assess the long-term effects of TRE. Statistical analysis will include the Anderson-Darling test for normality, T-test/Wilcoxon test based on distribution, mixed-effects models for assessing time/group effects, Cox model for time-to-event analysis, repeated ANOVA for change analysis, and sensitivity analysis. All tests will be conducted using appropriate software, with a significance level set at P<0.05. Missing data will be imputed. Discussion The purpose of this study protocol is to further evaluate the effects of TRE in overweight and obese women with PCOS through a randomized controlled trial (RCT). Findings from this study are expected to provide new dietary intervention strategies for overweight and obese PCOS participants. Ethics and dissemination This study has received ethics approval from the Medical Ethics Committee of the University of South China (Number: NHHL027). Participants are included after signing informed consent. Results will be submitted for publication in peer-reviewed journals. Trail registration Trail registration number: ChiCTR2400086815.
通讯机构：
[Yin, XH ] U;Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.
关键词：
Prehabilitation;Frailty;Aged;Meta-analysis
摘要：
Objective The study investigates the impact of preoperative rehabilitation on the surgical prognosis of frail older patients.
The study investigates the impact of preoperative rehabilitation on the surgical prognosis of frail older patients.
Method The effect sizes of all studies retrieved and included by the nine databases were analyzed and expressed as RR and WMD.
The effect sizes of all studies retrieved and included by the nine databases were analyzed and expressed as RR and WMD.
Results 8 studies with 902 participants met the criteria for inclusion. A significant reduction in total complications (RR = 0.84, 95 % CI = 0.73 to 0.97, P = 0.021) and the 6MWT after surgery (WMD = 74.76, 95 % CI = 44.75 to 104.77, P = 0.000) was observed in the prehabilitation group. But it had no differences in mortality(RR = 1.89, 95 % CI = 0.75 to 4.72, P = 0.176), readmission rates(RR = 1.04, 95 % CI = 0.56 to 1.91, P = 0.906) and LOS(WMD = -0.24, 95 % CI = -1.00 to 0.52, P = 0.540).
8 studies with 902 participants met the criteria for inclusion. A significant reduction in total complications (RR = 0.84, 95 % CI = 0.73 to 0.97, P = 0.021) and the 6MWT after surgery (WMD = 74.76, 95 % CI = 44.75 to 104.77, P = 0.000) was observed in the prehabilitation group. But it had no differences in mortality(RR = 1.89, 95 % CI = 0.75 to 4.72, P = 0.176), readmission rates(RR = 1.04, 95 % CI = 0.56 to 1.91, P = 0.906) and LOS(WMD = -0.24, 95 % CI = -1.00 to 0.52, P = 0.540).
Conclusions Prehabilitation had positive effect on postoperative complications and functional recovery in frail older patients.
Prehabilitation had positive effect on postoperative complications and functional recovery in frail older patients.
